Questionnaire Text

Questionnaire form view entire document: text image

12. In this dwelling is there a

Washing machine?

[] 1 Yes
[] 2 No

Questionnaire instructions view entire document: text image

Questions 3 to 14 only are asked at dwellings with occupants present classified in one of the circles 01 to 05 of question Number 1 "Type of Dwelling".

Question Number 12: In this dwelling is there a . . .?
Ask the question as it is written and read to the person all the appliances that are included in the questionnaire.
Mark with "X" the circles in agreement with the response that the person gives you.